::: Home
::: Health
Eligibility
Participation
Benefits
Preferred Provider
Prescription Drug
Dental Plan
Vision Care
Death Benefit
Employee Assistance
Employee AD&D
Weekly Disability
COBRA
HIPAA
Appeals Process
::: About
::: Contact
::: Administration
::: Legal Rights
::: Download Forms
::: Important Terms
::: Links
::: News
 

Home > Health Plan > Eligibility

Eligibility

Your Eligible Dependents

Once you become eligible for benefits, your eligible dependents are also covered under the medical, dental, prescription drug and vision care plans.
 

Eligible Dependents:

  • Your spouse
  • Unmarried children up to their 19th birthday, or age 23 if they are full time students at any eligible educational institution
  • (If your children are no longer eligible for coverage but return to full time student status prior to reaching the age of 23, and are unmarried, then their coverage will be reinstated on the date they resume full time student status.)
  • Unmarried children who cannot work because of a physical or mental disability and who depend on you for support, provided the disability began before age 19 (or age 23 for full time students)

Children include your natural children, stepchildren, foster children and legally adopted children. Children named under a Qualified Medical Child Support Order are also eligible. A copy of this order must be filed with the Fund To cover a child who is physically or mentally disabled, you must provide proof of the child's condition to the Fund Office within 31 days after the child reaches age 19 (or age 23 if full time student) or within 31 days after you become eligible for benefits, whichever is later. You will also be required from time to time to provide proof of your child's continued disability at the request of the Fund Office. To cover a dependent who is a full time student over the age of 19 (up to age 23), you must submit a letter from the school or college verifying full time student status each semester.

Termination of Coverage

Your Coverage will cease:

  1. The last day of the month  you cease to be actively at work in an eligible class of employees, EXCEPT THAT your employer may continue insurance as follows,
  2.  
    • Disability. If you are disabled, your coverage will be continued for six months during the disability if you conform to the requirements for continued disability benefits outlined in this SPD
    • Your dependent's eligibility will end when your participation ends, or when an individual dependent no longer qualifies as an eligible dependent
Termination of coverage will not affect any claims incurred while the policy is in force. Upon termination each plan participant will receive a COBRA Letter and a Certificate of Credible Coverage.

Reporting Changes in Family Status

You must notify the Beverage and Brewery Local 67 Health and Welfare Fund Office immediately if you have a change in family status or a change of address. A change in family status includes the following:

  • Getting married
  • Adding new dependents, including birth or adoption of a child and care of a foster child, or in the event of a Qualified Medical Child Support Order
  • Divorce or legal separation
  • Death of a dependent
  • When a dependent child is no longer eligible (i.e., upon turning age 19, or age 23, or upon loss of physically or mentally disabled status or full time student status under age 23, or upon return to full time student status)
  • When a change in your spouse s employment related health care coverage occurs; and
  • Upon obtaining eligibility of Medicare or Medicaid disability status as determined by Social Security
It is important that you notify the Fund when any of these events occur. You may have rights under the law when your status changes and the Fund may have reporting obligations related to those rights. Upon a change in family status during the year, you may change the number of family members enrolled under your medical plan, consistent with the change in family status.

If You Become Disabled

If you become disabled and received Weekly Disability benefits through the Health & Welfare Plan, you may remain eligible for medical benefits for up to 26 weeks of disability. For the first 16 weeks your employer will continue to pay the fund premium for the remaining 16 weeks the Fund will absorb the costs.

If you are disabled on the job and receive workers compensation benefits, your employer is required to continue contributions.

The plan does not cover medical expenses caused by a job related illness or injury. These expenses are covered by workers compensation insurance.

However, The Fund Office may pay you weekly disability benefits for any injury or accident that is disputed by your employer as being work related if you sign a lien in which you agree to reimburse the Fund in full from any settlement or recovery.

Coordinating with a Third Party
If your injury or illness is work related, no benefits are payable by the Beverage and Brewery Local 67 Health and Welfare benefit program. If a claim is made for Workers Compensation, the Teamsters Health and Welfare benefit program cannot process a medical claim for the same disability unless and until Workers Compensation determines that there is no basis for the claim. If you receive a settlement from a Workers Compensation claim, you cannot claim benefits for the same disability from the Brewery and Beverage Health and Welfare Program.

Continuation of Dependent Insurance After Your Death

If you are eligible for dependent coverage when you die, your dependent(s) who are covered for the benefits set forth below will remain so insured while the dependent insurance remains in force. The policy will remain in effect until 30 days after your death. At which time you will receive a COBRA letter from the Administrator explaining the costs and options to you under Law.

 

 
     

Important Notice: This website provides only a brief explanation of the Health and Welfare Plan under the Beverage and Brewery Local 67 Health and Welfare Trust Fund. It is not a summary plan description. If there are any inconsistencies between this explanation and the Plan document, the Plan document shall control. Also, please refer to the Summary Plan Description for additional information about the benefits available and procedures of the Beverage and Brewery Local 67 Health and Welfare Trust Fund or contact the Welfare Fund Office.

Copyright 2007 Teamsters Local 67. All Rights Reserved
2120 Bladensburg Rd., NE
 Washington, DC 20018